Comparing medical billing software

Medical Billing Services Buyer's Guide

In most cases, you'll be using a software system provided by the vendor to enter information and get reports. This includes both web-based systems and software that runs on your computers. Here are some factors to consider when evaluating medical billing software.

Who owns the medical billing software?
You'll find that some billing services develop their own applications, while others license the software from a third party.

Companies that own their own systems have the advantage of being able to control the future of the system. Your requests for improvements and bug fixes are more likely to be heard, and you can be sure that the software will continue to be supported and upgraded as long as you stay with the service.

On the other hand, services that license their platforms from a third-party developer can be more focused on actually running the billing for their clients and getting claims paid, since they don't also have to do software development.

If you choose a billing service that licensees their software from another developer, make sure you do some investigation of that company, as well – be sure that they a strong customer base to keep them in business for the long term. Note: one quick way to evaluate a company is to track the history of releases; continuous improvements can be a good indicator of support.

Web-based vs. local software
You'll probably encounter two types of medical billing software: web-based and local software. Web-based systems, also known as ASP solutions, require you to log in and enter your information through a web site, while local software runs on the computers in your office. Since a central part of medical billing is transmitting protected patient data to the provider, both options must meet stringent HIPAA security requirements.

Running your software locally may increase the burden on the staff that maintains your computers, but vendors should offer considerable technical support if needed. Using a web-based service means that you won't be able to access your information if your Internet access goes down.

Both options can provide secure, reliable medical billing. Unless you have internal IT staff with a strong preference for one method or the other, it's best to keep your options open.

Usability
When evaluating billing providers, make sure you get a hands-on demonstration of the software you'll use to enter your claims information. When comparing different software clients, there's no substitute for actually sitting down and entering the information yourself.

See how easy it is to enter and find information. Try your most common tasks – entering a typical bill, looking up an individual patient's claims status, or reviewing your oldest claims. Are the commands and buttons intuitive and easy to find? Can you undo mistakes or retrace your steps easily?

It may help to have one of your billing staff go through this part of the evaluation. They're more familiar with the process and are in a better position to evaluate the system’s usability.

Security
The application you choose must include security measures that meet HIPAA standards and ensure patient confidentiality.

• SSL is a standard method for communicating securely over the Internet as well as a HIPAA requirement.
• Multiple access levels give you the ability to allow different staffers varying amounts of access: billing clerks, for example, could be allowed view-only access to diagnoses and procedures.
• Change logs keep track of what information users access and/or edit, which can be essential if security is compromised.

For even greater security, some medical billing software systems allow you to restrict access by time of day or IP address, meaning only certain computers would be allowed to access the data at all.

Infrastructure
Whether you enter claims through a web client or local software, your critical billing information and confidential patient data is all stored on the provider's computers once you transmit it. Ask about the type of infrastructure they have in place to see how safe it will really be. Among the important safeguards they should have are regular offsite backups, physically secure computers, backup power, and redundant servers.